NPI Lookup – Keeping Up-to-Date

npi lookup

What is an NPI Number?

An NPI or National Provider Identifier number is created to ensure accuracy and efficiency in the healthcare system to prevent fraud and abuse. In October of 2006, the Centers of Medicare and Medicaid Services (CMS) began issuing NPI numbers to each healthcare provider. Commercial insurers use these valid 10-digit NPI numbers as well to conduct NPI searches.

NPI Lookup

NPI lookup helps verify eligibility for persons or organizations that they are not in the OIG LEIE exclusion list. Conducting NPI search through the NPI database will help verify complete eligibility for physicians, doctors, nurses, therapists, technicians and other healthcare medical providers covered by HIPAA. Additionally, NPI or National Provider Information lookup also helps verify eligible hospitals and medical groups.

It is important to note that NPI is the only healthcare provider identifier that can be use for identification purposes in standard transactions for covered individuals, organizations or groups.The Health Insurance Portability and Accountability Act (HIPAA) requires that covered entities use NPI numbers in standard transactions.

How to perform NPI Registry Search?

An NPI registry search can be done by simply conducting the NPI search by name, and thereby obtain the NPI number, or alternatively, search the NPI registry, and hone in on the ones under scrutiny, find their NPI, and then search via the NPI number.

Keeping Up-to-Date

The Centers of Medicare and Medicaid Services (CMS) updates NPI database on a weekly basis, providing simply the “delta” of changes from the week before. Each month, however, the NPI file is replaced fully. When checking your employees and workers, therefore, make sure that you have the current “incremental” NPI file, and that when the monthly update takes place, you are using the most recent version of the database.

The Automated Solution
Online solutions such as Streamline Verify’s web application uses NPI numbers to make the exclusion screening process even more streamlined. Once clients provide the NPI numbers of their providers and upload it to their account, their application is able to run it against the OIG LEIE and all exclusion databases and deliver back in seconds any matching NPIs. This assures their clients/customers that any NPI matches are accurate and up-to-date that helps them stay in compliance.

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